NOX-A12 in Combination With Bortezomib and Dexamethasone in Relapsed Multiple Myeloma
Primary Purpose
Multiple Myeloma
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
NOX-A12
Sponsored by

About this trial
This is an interventional treatment trial for Multiple Myeloma focused on measuring Relapsed Multiple Myeloma, NOX-A12, Velcade, Dexamethasone, Spiegelmer, Chemosensitization, Stromal cell-derived factor-1 (SDF-1), CXCL12
Eligibility Criteria
Inclusion Criteria:
- Male or female, aged ≥ 18 years.
- Diagnosis of relapsed multiple myeloma for which bortezomib/dexamethasone would be given as standard of care.
- Bortezomib-naïve or bortezomib-sensitive patient (i.e. best response of PR or better, sustained for at least 6 months), who did not receive bortezomib during the last line of therapy for MM prior to this study.
- Progressive disease according to International Myeloma Working Group criteria.
- Pre-study WHO Performance Status ≤ 2 and modified CIRS score of less than 7.
- Signed and dated, written informed consent.
- Men and women of reproductive potential must agree to follow accepted contraception methods during treatment and for 3 months after completion of treatment.
- Acceptable liver function: Bilirubin ≤ 1.5 x upper limit of normal (ULN).
- Acceptable hematology and hemostasis status: Platelet count ≥ 75 x 109/L, ANC > 0.75x109/L.
- Acceptable renal function: Serum creatinine ≤1.5 ULN and/or calculated creatinine clearance ≥ 50 mL/min (calculated according to Cockroft & Gault formula).
- No clinically significant abnormalities of liver volume, liver hemodynamics or elasticity, measured by abdominal ultrasound.
Exclusion Criteria:
- The patient has a history of, or is clinically suspicious for, cancer-related Central Nervous System disease.
- Prior allogeneic stem cell transplant (alloSCT) or patients who are considered to be candidates for alloSCT as assessed by their treating physician.
- Patient has a history of other active malignancies within 3 years prior to study entry, with the exception of: adequately treated in situ carcinoma of the cervix uteri; basal or squamous cell carcinoma of the skin; in situ carcinoma of the bladder; previous malignancy confined and surgically resected with curative intent.
- The patient exhibits evidence of other clinically significant uncontrolled condition(s) including, but not limited to: uncontrolled systemic infection (viral, bacterial, or fungal); diagnosis of fever and neutropenia within 1 week prior to study drug administration.
- Female patient is pregnant or breast-feeding.
- Known infection with HIV, active Hepatitis B or Hepatitis C.
- The patient has a history of prior toxicity from bortezomib or dexamethasone that resulted in permanent discontinuation of respective treatments.
- Clinical evidence of a current significant (grade 2 or higher) or progressive neuropathy.
- Treatment with any other investigational agent, or participation in another clinical trial within 30 days prior to study drug administration.
- Uncontrolled hypertension (defined as systolic blood pressure [BP] > 160 mm Hg or diastolic BP > 100 mm Hg).
- Myocardial infarction or unstable angina within the past 6 months prior to study drug administration. Heart failure of New York Heart Association functional Class III or IV prior to study drug administration.
- Evidence of bleeding diathesis (greater than normal risk of bleeding) or coagulopathy (in the absence of therapeutic anticoagulation).
- Systemic illnesses or other severe concurrent disease or alcoholism, which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and efficacy of the investigational treatments.
- Known or suspected of not being able to comply with the trial protocol.
- Having been previously enrolled in this clinical trial.
Sites / Locations
- University Hospital Salzburg, Department of Medicine III, Center of Oncology and Hematology
- Wilhelminenspital, Department of Medicine I, Center of Oncology and Hematology
- Hôpital Huriez, Centre Hospitalier Régional Universitaire de Lille
- Hôpital Saint Antoine - Service des maladies du sang et de thérapie cellulaire
- University Hospital Freiburg, Medizinische Universitätsklinik, Innere Medizin I, Haematologie und Onkologie
- University Hospital Münster, Medizinische Klinik und Poliklinik A
- University Hospital Ulm, Zentrum für Innere Medizin,
- University Hospital San Martino, Department of Hematology and Oncology
- Niguarda Ca'Granda Hospital, Department of Hematology
- Sapienza University of Rome, Department of Hematology
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
NOX-A12
Arm Description
Outcomes
Primary Outcome Measures
Overall response rate (ORR = best response at least partial response (PR))
Assessment of the overall tumor response after cycle 4 and 8 will be the primary efficacy endpoint. The recommendations for the uniform reporting of clinical trials as published by the International Myeloma Workshop Consensus Panel 1 in 2011 will be applied.
Safety and tolerability of NOX A12 alone and in combination with VD
The safety evaluation will be based on the following assessments:
Adverse events
Vital signs
12 lead ECGs
Laboratory parameters
Abdominal ultrasound
Immunogenicity
Secondary Outcome Measures
Effect of NOX A12 alone and combined with VD on the mobilization of peripheral blood CD34+ cells, plasma cells and myeloma cells
Additional response criteria such as Minor Response (MR), immunophenotypic Complete Response and molecular Complete Response
Time to event endpoints such as Progression Free Survival (PFS), Time To Progression (TTP) and Duration Of Response (DOR) following treatment with NOX A12 in combination with VD
Plasma concentration of SDF-1 after treatment with NOX-A12 alone (pilot group only) and in combination with VD
Pharmacokinetics of NOX A12 alone (pilot group only) and combined with VD
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01521533
Brief Title
NOX-A12 in Combination With Bortezomib and Dexamethasone in Relapsed Multiple Myeloma
Official Title
A Multi-center, Open Label, Uncontrolled, Phase IIA Clinical Trial Evaluating the Safety and Efficacy of NOX A12 in Combination With a Background Therapy of Bortezomib and Dexamethasone (VD) in Previously Treated Patients With Multiple Myeloma (MM)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
March 2012 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
September 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TME Pharma AG
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the safety and efficacy of NOX A12 alone and in combination with a background therapy of bortezomib and dexamethasone (VD) chemotherapy in previously treated patients with multiple myeloma (MM).
Detailed Description
Malignant plasma cells express high levels of CXCR4 chemokine receptors, which cause cell migration and adhesion to stromal cells secreting the CXCR4 ligand, CXCL12 (SDF-1). NOX A12 is a specific CXCL12 antagonist and may improve chemotherapy by disrupting CXCR4-CXCL12 interactions, thereby mobilizing plasma cells from protective tissue microenvironments to the blood. Furthermore, SDF-1 inhibition may alter the activation status of plasma cells, thereby triggering apoptosis or sensitization of plasma cells towards chemotherapy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Relapsed Multiple Myeloma, NOX-A12, Velcade, Dexamethasone, Spiegelmer, Chemosensitization, Stromal cell-derived factor-1 (SDF-1), CXCL12
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
28 (Actual)
8. Arms, Groups, and Interventions
Arm Title
NOX-A12
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
NOX-A12
Other Intervention Name(s)
olaptesed
Intervention Description
Pilot Group (NOX A12 single agent, and combined with VD):
3 cohorts of 3 patients will receive treatment with NOX A12 alone at a single dose of 1, 2 or 4 mg/kg i.v. 2 weeks before the combination treatment of NOX A12 and VD will start. The combination of NOX A12 and VD will follow a dose titration design beginning at 1 mg/kg NOX A12 (cycle 1) proceeding to dose levels of 2 mg/kg (cycle 2) and 4 mg/kg (cycle 3) NOX A12 in combination with VD. This is followed by consolidation in cycles 4-8 when NOX-A12 will be kept at the highest individually titrated dose.
Expansion Group (NOX A12 in combination with VD):
Expansion patients will not receive single agent NOX-A12, but will receive combination treatment as for the pilot group.
Primary Outcome Measure Information:
Title
Overall response rate (ORR = best response at least partial response (PR))
Description
Assessment of the overall tumor response after cycle 4 and 8 will be the primary efficacy endpoint. The recommendations for the uniform reporting of clinical trials as published by the International Myeloma Workshop Consensus Panel 1 in 2011 will be applied.
Time Frame
6 months
Title
Safety and tolerability of NOX A12 alone and in combination with VD
Description
The safety evaluation will be based on the following assessments:
Adverse events
Vital signs
12 lead ECGs
Laboratory parameters
Abdominal ultrasound
Immunogenicity
Time Frame
18 months
Secondary Outcome Measure Information:
Title
Effect of NOX A12 alone and combined with VD on the mobilization of peripheral blood CD34+ cells, plasma cells and myeloma cells
Time Frame
6 months
Title
Additional response criteria such as Minor Response (MR), immunophenotypic Complete Response and molecular Complete Response
Time Frame
6 months
Title
Time to event endpoints such as Progression Free Survival (PFS), Time To Progression (TTP) and Duration Of Response (DOR) following treatment with NOX A12 in combination with VD
Time Frame
18 months
Title
Plasma concentration of SDF-1 after treatment with NOX-A12 alone (pilot group only) and in combination with VD
Time Frame
6 months
Title
Pharmacokinetics of NOX A12 alone (pilot group only) and combined with VD
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female, aged ≥ 18 years.
Diagnosis of relapsed multiple myeloma for which bortezomib/dexamethasone would be given as standard of care.
Bortezomib-naïve or bortezomib-sensitive patient (i.e. best response of PR or better, sustained for at least 6 months), who did not receive bortezomib during the last line of therapy for MM prior to this study.
Progressive disease according to International Myeloma Working Group criteria.
Pre-study WHO Performance Status ≤ 2 and modified CIRS score of less than 7.
Signed and dated, written informed consent.
Men and women of reproductive potential must agree to follow accepted contraception methods during treatment and for 3 months after completion of treatment.
Acceptable liver function: Bilirubin ≤ 1.5 x upper limit of normal (ULN).
Acceptable hematology and hemostasis status: Platelet count ≥ 75 x 109/L, ANC > 0.75x109/L.
Acceptable renal function: Serum creatinine ≤1.5 ULN and/or calculated creatinine clearance ≥ 50 mL/min (calculated according to Cockroft & Gault formula).
No clinically significant abnormalities of liver volume, liver hemodynamics or elasticity, measured by abdominal ultrasound.
Exclusion Criteria:
The patient has a history of, or is clinically suspicious for, cancer-related Central Nervous System disease.
Prior allogeneic stem cell transplant (alloSCT) or patients who are considered to be candidates for alloSCT as assessed by their treating physician.
Patient has a history of other active malignancies within 3 years prior to study entry, with the exception of: adequately treated in situ carcinoma of the cervix uteri; basal or squamous cell carcinoma of the skin; in situ carcinoma of the bladder; previous malignancy confined and surgically resected with curative intent.
The patient exhibits evidence of other clinically significant uncontrolled condition(s) including, but not limited to: uncontrolled systemic infection (viral, bacterial, or fungal); diagnosis of fever and neutropenia within 1 week prior to study drug administration.
Female patient is pregnant or breast-feeding.
Known infection with HIV, active Hepatitis B or Hepatitis C.
The patient has a history of prior toxicity from bortezomib or dexamethasone that resulted in permanent discontinuation of respective treatments.
Clinical evidence of a current significant (grade 2 or higher) or progressive neuropathy.
Treatment with any other investigational agent, or participation in another clinical trial within 30 days prior to study drug administration.
Uncontrolled hypertension (defined as systolic blood pressure [BP] > 160 mm Hg or diastolic BP > 100 mm Hg).
Myocardial infarction or unstable angina within the past 6 months prior to study drug administration. Heart failure of New York Heart Association functional Class III or IV prior to study drug administration.
Evidence of bleeding diathesis (greater than normal risk of bleeding) or coagulopathy (in the absence of therapeutic anticoagulation).
Systemic illnesses or other severe concurrent disease or alcoholism, which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and efficacy of the investigational treatments.
Known or suspected of not being able to comply with the trial protocol.
Having been previously enrolled in this clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kai Riecke, MD
Organizational Affiliation
TME Pharma AG
Official's Role
Study Director
Facility Information:
Facility Name
University Hospital Salzburg, Department of Medicine III, Center of Oncology and Hematology
City
Salzburg
Country
Austria
Facility Name
Wilhelminenspital, Department of Medicine I, Center of Oncology and Hematology
City
Vienna
Country
Austria
Facility Name
Hôpital Huriez, Centre Hospitalier Régional Universitaire de Lille
City
Lille
Country
France
Facility Name
Hôpital Saint Antoine - Service des maladies du sang et de thérapie cellulaire
City
Paris
Country
France
Facility Name
University Hospital Freiburg, Medizinische Universitätsklinik, Innere Medizin I, Haematologie und Onkologie
City
Freiburg
Country
Germany
Facility Name
University Hospital Münster, Medizinische Klinik und Poliklinik A
City
Münster
Country
Germany
Facility Name
University Hospital Ulm, Zentrum für Innere Medizin,
City
Ulm
Country
Germany
Facility Name
University Hospital San Martino, Department of Hematology and Oncology
City
Genova
Country
Italy
Facility Name
Niguarda Ca'Granda Hospital, Department of Hematology
City
Milano
Country
Italy
Facility Name
Sapienza University of Rome, Department of Hematology
City
Rome
Country
Italy
12. IPD Sharing Statement
Citations:
PubMed Identifier
30957581
Citation
Park EJ, Choi J, Lee KC, Na DH. Emerging PEGylated non-biologic drugs. Expert Opin Emerg Drugs. 2019 Jun;24(2):107-119. doi: 10.1080/14728214.2019.1604684. Epub 2019 Apr 19.
Results Reference
derived
Learn more about this trial
NOX-A12 in Combination With Bortezomib and Dexamethasone in Relapsed Multiple Myeloma
We'll reach out to this number within 24 hrs